EMAN RESEARCH PUBLISHING | Journal | <p>A Rare Case of Acute Myocardial Infarction Due to Coronary Artery Dissection and Heparin-Induced Thrombocytopenia</p>
Inflammation Cancer Angiogenesis Biology and Therapeutics | Impact 0.4 (CiteScore) | Online ISSN  2207-872X
CASE STUDY   (Open Access)

A Rare Case of Acute Myocardial Infarction Due to Coronary Artery Dissection and Heparin-Induced Thrombocytopenia

Nikath Nasreen N, Kaavya M, Logeswari B M, Blessy John

+ Author Affiliations

Journal of Angiotherapy 5(2) https://doi.org/10.25163/angiotherapy.52621622920201221

Submitted: 30 November 2021  Revised: 11 December 2021  Published: 20 December 2021 

The patient’s acute coronary syndrome likely resulted from the combination of endothelial disruption from coronary artery dissection in the context of chest trauma, compounded by acute thrombosis, coronary occlusion, and subsequent myocardial infarction due to heparin-induced thrombocytopenia.

Abstract


Background: Although both coronary artery dissection and heparin-induced thrombocytopenia may provoke myocardial infarction, it is extremely rare for both conditions to develop simultaneously in a single patient. We report a case of a 69-year-old woman who sustained a head-on motor vehicle accident with associated chest trauma. Methodology: During a subsequent hospitalization, she was exposed to subcutaneous heparin and developed significant thrombocytopenia. Shortly after that, she was represented with acute myocardial infarction. Result: Coronary angiography revealed a spiral dissection with superimposed thrombosis within the right coronary artery, while laboratory testing confirmed the diagnosis of heparin-induced thrombocytopenia. She was treated with catheter-based thrombectomy and adjunctive direct thrombin inhibitor therapy, followed by three months of systemic anticoagulation with warfarin. Conclusion: To our knowledge, this represents the first published case of a native vessel myocardial infarction due to the combination of coronary artery dissection and heparin-induced thrombocytopenia.

Keywords: myocardial infarction, coronary artery dissection, and heparin-induced thrombocytopenia.

References


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